Influence of socio-economic status on functional recovery after ARDS caused by SARS-CoV-2: the multicentre, observational RECOVIDS study
Authors: Pierre-Louis Declercq, Isabelle Fournel, Matthieu Demeyere, Anissa Berraies, Eléa Ksiazek, Martine Nyunga, Cédric Daubin, Alexandre Ampere, Bertrand Sauneuf, Julio Badie, Agathe Delbove, Saad Nseir, Elise Artaud-Macari, Vanessa Bironneau, Michel Ramakers, Julien Maizel, Arnaud-Felix Miailhe, Béatrice Lacombe, Nicolas Delberghe, Walid Oulehri, Hugues Georges, Xavier Tchenio, Caroline Clarot, Elise Redureau, Gaël Bourdin, Laura Federici, Mélanie Adda, David Schnell, Mehdi Bousta, Charlotte Salmon-Gandonnière, Thierry Vanderlinden, Gaëtan Plantefeve, David Delacour, Cyrille Delpierre, Gurvan Le Bouar, Nicholas Sedillot, Gaëtan Beduneau, Antoine Rivière, Nicolas Meunier-Beillard, Stéphanie Gélinotte, Jean-Philippe Rigaud, Marie Labruyère, Marjolaine Georges, Christine Binquet, Jean-Pierre Quenot, Mélody De Jesus, Sébastien Normant, Jean-Nicolas Dacher, Thomas Stoup, Christophe Vinsonneau, Anne Dewatine, Pierre Cuchet, Delphine Rots, Julien Calus, Gabriel Le Moel, Pierre Kalfon, Gaëtan Badre, Jean-François Roy, Damien Roux, Jean-Damien Ricard, Marie Marcq, Thomas Georges, Caroline Pouplet, Laurie Lagache, Nicolas Masson, Matthieu Devos, Raphaël Favory, Sébastien Preau, Alexandre Gaudet, Pierre Bouju, Lidia Nichita, Pascal Maignan, Laurence Labourot, Francesco Molinari, Laurence Thirard, Charlotte Larrat, Fernando Berdaguer, Meltem Karakaya Akgun, Yannick Fedun, Thiphaine Guy, Marie Gousseff, Déborah Boyer, Tristan Bonnevie, Elsa Demarest, Sami Hraiech, Aude Sylvestre, Céline Sanz, Anne Veinstein
Journal: Intensive Care Medicine (2023)

Survivors after acute respiratory distress syndrome (ARDS) due to coronavirus disease 2019 (COVID-19) are at high risk of developing respiratory sequelae and functional impairment. The healthcare crisis caused by the pandemic hit socially disadvantaged populations. We aimed to evaluate the influence of socio-economic status on respiratory sequelae after COVID-19 ARDS. We carried out a prospective multicenter study in 30 French intensive care units (ICUs), where ARDS survivors were pre-enrolled if they fulfilled the Berlin ARDS criteria. For patients receiving high flow oxygen therapy, a flow ≥ 50 l/min and an FiO2 ≥ 50% were required for enrollment. Socio-economic deprivation was defined by an EPICES (Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé - Evaluation of Deprivation and Inequalities in Health Examination Centres) score ≥ 30.17 and patients were included if they performed the 6-month evaluation. The primary outcome was respiratory sequelae 6 months after ICU discharge, defined by at least one of the following criteria: forced vital capacity < 80% of theoretical value, diffusing capacity of the lung for carbon monoxide < 80% of theoretical value, oxygen desaturation during a 6-min walk test and fibrotic-like findings on chest computed tomography. Among 401 analyzable patients, 160 (40%) were socio-economically deprived and 241 (60%) non-deprived; 319 (80%) patients had respiratory sequelae 6 months after ICU discharge (81% vs 78%, deprived vs non-deprived, respectively). No significant effect of socio-economic status was identified on lung sequelae (odds ratio (OR), 1.19 [95% confidence interval (CI), 0.72–1.97]), even after adjustment for age, sex, most invasive respiratory support, obesity, most severe P/F ratio (adjusted OR, 1.02 [95% CI 0.57–1.83]). In COVID-19 ARDS survivors, socio-economic status had no significant influence on respiratory sequelae 6 months after ICU discharge.